A wide number of surgical procedures employ surgical clips (i.e., ligation clips). Such surgical procedures may require vessels, organs or other tissues of the human body to be ligated. Surgical clips ligate, clamp, close off or otherwise occlude the engaged portion of the clamped vessels, organs or other tissues in a surgical site. Such clips may also be used to secure the ends of a suture, as in place of a conventional suture knot.
Ligation can be performed with a ligating clip (i.e., a surgical clip) or by suturing with surgical thread. Suturing requires complex manipulations of the needle and suture material to form the knots required to secure the vessel. Such complex manipulations are time-consuming and difficult to perform, particularly in endoscopic surgical procedures, which are characterized by limited space and visibility. By contrast, ligating clips are relatively easy and quick to apply. So long as the clips and applicator are designed with endoscopic procedures in mind, they are a preferred choice.
The clips are often in the form of thin, narrow, metal or polymeric U-shaped or V-shaped members that are placed over the vessel, tissue or suture material and then forced into a closed position using a clip applicator. Clips constructed of metal, may be initially open and then permanently deformed into a closed or clamped configuration around the desired blood vessel or other tissue structure using an appropriate clip applicator. However, metal clips, which are radio-opaque, interfere with x-ray imaging. Plastic clips include a latch feature to ensure that the clip remains closed with sufficient force to provide full and complete hemostasis or occlusion and to ensure that the clip will not loosen or open over time.
While ligating clips are an improvement over suturing in many procedures, they suffer shortcomings. First the clips typically require a surgical plane or window to be made prior to attachment. Conventional clips are not configured to penetrate tissue. Accurate planning and windowing manipulations are time-consuming and difficult to perform, particularly in endoscopic surgical procedures, which are characterized by limited space and visibility. Furthermore, creating windows can cause extensive bleeding, leading to decreased visibility.
Second, the clips tend to slip as they are applied. Slipping makes accurate placement extremely difficult. To overcome slipping, excessive force may be applied, which can damage the clamped vessel, tissue or organ. Additionally, forces applied during slipping may cause the contact surfaces of the clamping arms to deviate from parallel.
Third, the clips are extremely difficult to remove. Conventional clips include relatively thick hinge and arm sections that abut and occlude a clamped vessel or tissue. The latch is not releasable. Cutting through such a clip without damaging the clamped vessel or tissue is extremely difficult.
Fourth, conventional clip applicators provide a very limited range of positioning and orientation. This limitation makes accurate placement time-consuming and difficult to perform, particularly in endoscopic surgical procedures, which are characterized by limited space and visibility.
The invention is directed to overcoming one or more of the problems and solving one or more of the needs as set forth above.